STOP Early Journal Content on JSTOR, Free to Anyone in the World This article is one of nearly 500,000 scholarly works digitized and made freely available to everyone in the world by JSTOR. Known as the Early Journal Content, this set of works include research articles, news, letters, and other writings published in more than 200 of the oldest leading academic journals. The works date from the mid-seventeenth to the early twentieth centuries. We encourage people to read and share the Early Journal Content openly and to tell others that this resource exists. People may post this content online or redistribute in any way for non-commercial purposes. Read more about Early Journal Content at http://about.jstor.org/participate-jstor/individuals/early- journal-content . JSTOR is a digital library of academic journals, books, and primary source objects. JSTOR helps people discover, use, and build upon a wide range of content through a powerful research and teaching platform, and preserves this content for future generations. JSTOR is part of ITHAKA, a not-for-profit organization that also includes Ithaka S+R and Portico. For more information about JSTOR, please contact email@example.com. September 16, 1910 1286 CALCUTTA— Cholera ana Plague. Acting Assistant Surgeon Allan reports, August 11: During the week ended July 23 there were 18 deaths from cholera and 17 from plague in Calcutta; in all Bengal, 31 cases of plague with 31 deaths; in all India, 737 cases with bol deaths. ITALY. The Cholera Outbreak. Surg. H. D. Geddings at Naples reports, August 28, as follows: The announcement of the presence of cholera in Italy August 17 came as a complete surprise. There had been no disturbing rumors, although the cholera situation in the Black Sea provinces of Russia had become disquieting and had led to renewed precautions in the handling of emigrants destined for the United States. On August 18 a circu- lar letter was addressed by this office to all steamship agencies in Naples announcing the enforcement of the quarantine regulations of the United States in regard to cholera. During the afternoon of August 17 and the morning of August 18 about 80 passengers of the steerage class were placed under observation in a special boarding house designated by the Italian inspector of emigration at this port. Origin of the infection. — Reliable information gives the cause of the outbreak as the debarkation at Brindisi of a party of Russian gypsies from Batum, who proceeded by rail to Trani, which is to be regarded as the primary focus of the epidemic. Whether any of the wanderers were ill upon arrival admits of doubt; but it is certain that arriving in Trani they washed clothing in vessels used for drawing water from a well, and in due course there followed cases of choleri- form disease, the nature of which was not immediately recognized, and which were regarded by the authorities as "grave gastro-intestinal disturbances." The infection spread to various towns and cities in the provinces of Bari and Foggia, both in the region of Apulia. The town of Trani has up to this time suffered most severely, and it is to be regarded as the primary focus of infection, the outbreak partaking of the characteristics of a water-borne epidemic. The infection at other points is secondary, and the nature of the spread ap to this time points to "contact" outbreaks. Extent of the infection. — To this time the disease has made its appearance in the following places: In the province of Bari, at Andria, Trani, Corato, Bitonto, Spinazzola, Barletta, Bari, and Bisceglie. In the province of Foggia, at Cerignola, Trinitapoli, San E'erdinando di Puglia, and Margherita di Savoia. The province of Lecce at this date remains free from infection, and it is to be remembered that these three provinces compose the region or district of Apulia. The following figures represent as nearly as can be arrived at the incidence and mortality up to and including August 20: Cases. Deaths. SO 33 16 10 9 8 1 1 2 2 1 1 1 Trani Barletta Andrea Bitonto Bisceglie... Spinazzola . "Sari 1287 September 16, 1910 The statistical information from the other points is not at this date available, but the number of cases and deaths is small. Measures taken by the authorities. — Inspectors and commissioners were promptly sent from the central sanitary office at Rome to the infected district and the measures taken by them have been thorough and seem to have had good results. The situation to-day is considerably im- proved. Travel in the infected district is being restricted and regu- lated; towns are being cleaned and put in better sanitary condition, and arrangements have been made for the distribution of drinking water from the aqueduct of Ofanto, a source of great purit}^. Bari will receive 150 cubic meters daily, and Barletti, Trani, and Bisceglie, each about 100 cubic meters. Prohibitions have already been put in force as to the sale of fruits, especially melons, tomatoes, cucumbers, and other articles of food, such as snails, oysters, and mussels. The exportation of fruits, vegetables, etc., from the infected districts has also been prohibited. Hospitals have been organized in all towns, and large quantities of disinfectants have been distributed, while all doubt- ful wells have been closed, and all suspected cisterns have been ordered cleaned and refilled with the pure water mentioned above. Special precautions have also been taken at all the ports which have Russian connections. Conditions in Naples. — Naturally there is some uneasiness in Naples, and the sanitary authorities have been spurred to great activity. With the careful regulation of railroad travel much of the risk to Naples will be removed. The water supply of the city is such, and its source is so removed from all human habitation, and so carefully policed and guarded, that a water-borne epidemic of cholera is, humanly speaking, impossible. But should cases be introduced into the lower quarters of the city, there would undoubtedly be contact epidemics or at least outbreaks. Sanitary matters are receiving the careful consideration of the proper authorities, and there is no sense of false security with its attendant danger. The relation of the outbreak to emigration. — This aspect of the sub- ject is the one of the most importance to the sanitary authorities of the United States, and I am glad to be able to report a satisfactory condition of affairs. As previously mentioned, detention of persons and the disinfection of their baggage and effects was begun coinci- dently with the first alarm. The Italian commissioner-general of emi- gration came at once to Naples, and with him and the representatives of the various steamship companies arrangements have been com- pleted as follows: I. Pending the inauguration of measures to be hereafter detailed the movement of emigration from the infected provinces to Naples by rail will be prohibited. II. As soon as the necessary arrangements can be made, all would- be emigrants from the infected provinces will be collected in a clean town, under proper sanitary regulations, and brought to Naples on special trains, which trains will be under the supervision of military medical officers, and the trains will be equipped with all necessary emergency supplies and provided with a sufficient force of military hospital stewards and nurses. III. Arriving in Naples, the emigrants will be carried from a special station, on special tenders or lighters, to a hospital or receiving ship which will be moored off the end of the mole. This ship will be September 16, 1910 1288 capable of receiving 400 or more emigrants, will have some bathing facilities, a sulphur furnace, facilities for the disinfection of the cloth- ing in which the emigrants arrive, special arrangements for the disin- fection of all excreta prior to discharge into the waters of the bay, a clinical laboratory for diagnostic use, and in addition to the regular complement will have on duty a naval medical officer and a force of naval stewards and nurses, and to this ship Acting Assistant Surgeon Buonocore and 1 will have access at all times. Under these condi- tions the emigrants will be detained five full days, and then brought to the regular place of embarkation for the medical examination. The present shore facilities for the disinfection of personal effects are ample and are under our control. Should any case of cholera mate its appearance on the receiving ship, the ship, with all on board, will at once put to sea and repair to the quarantine station on the Island of Sardinia and her place will be taken by another ship. The vessel will be ready for the reception of passengers August 29. Doctor Geddings further reports, August 29: Status of Cnolera In Italy during tne Weak ended August 27. Deaths. Province of Bari: Andria Barletta Bitonto Canosa Grumo Appula Molfetta Euvo Spinazzola Trani Province of Foggia: Cerignola San Ferdinando Margherila di Savoia Ortanova Trinitapoli Province of P tenza: Genzano Palazzo San Gervasio IS 9 68 46 1 6 2 1 2 3 1 6 2 33 29 8 2 1 3 9 7 1 16 5 ■?, 1 1 1 Genzano and Palazzo San Gervaso are in the district of the Province of Potenza which adjoins the Province of Bari.